心肺バイパスの神経行動的続変
O A Selnes1, M A Goldsborough, L M Borowicz
1Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Lancet (London, England)
|May 20, 1999
まとめ
冠動脈バイパス移植 (CABG) は,持続的な欠陥を含む有害な神経認知的結果につながる可能性があります. リスクのある患者を特定することは,手術の結果と患者のケアを改善するために不可欠です.
科学分野:
- 心血管外科手術についてです.
- 神経科学は神経科学である.
- 認知心理学とは,認知心理学である.
背景:
- 冠動脈バイパス移植 (CABG) は著しく進歩し,アンギナ管理を改善しました.
- 脳卒中や認知機能の欠陥を含む有害な神経行動的アウトカムが,CABGの後も懸念事項となっている.
- CABG後の脳卒中の術前リスク要因が特定されています.
研究 の 目的:
- CABGの後の神経認知的アウトカムを見直す.
- CABG後の認知機能低下に関連する危険因子を特定する.
- 有害な神経認知的結果から患者を保護するための戦略について議論する.
主な方法:
- CABG後の神経認知的アウトカムに関する研究の文献レビュー.
- 人口統計学的および医学的なリスク要因の分析.
- 短期的および長期的認知欠陥の検討.
- 術前うつ病を要因として考慮する.
主要な成果:
- 短期的な認知欠陥は,CABG後によく見られるが,処置特異的ではないかもしれない.
- 視覚構造の欠陥は長期にわたって持続し,潜在的に脳損傷によるものです.
- 術前うつ病はしばしば手術後も続くが,認知機能の低下を完全に説明することはない.
- 認知機能低下のリスク要因は,短期研究と長期研究によって異なる可能性があります.
結論:
- CABGの進歩にもかかわらず,神経認知症の合併症は続いている.
- 有害な神経認知的アウトカムのリスクのある患者を特定することは不可欠です.
- リスクの高い患者を保護するために,手術手順の変更と効果的な医療療法が必要である.
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